Benjamin Lindquist1, Sybil Zachariah2, Anita Kulkarni3. 1. Former Emergency Medicine Resident in the Stanford/Kaiser Emergency Medicine Residency Program in Stanford, CA. blindquist2@gmail.com. 2. Emergency Medicine Resident in the Stanford/Kaiser Emergency Medicine Residency Program in Stanford, CA. szachar2@gmail.com. 3. Emergency Physician at the Santa Clara Medical Center in CA. anita.kulkarni@kp.org.
Abstract
INTRODUCTION: Emergency Departments are inundated by patients with respiratory illness during the winter months. Emergency physicians are required to quickly identify critically ill patients among the large volume of patients with mild upper respiratory illness. Among these life-threatening conditions is acute epiglottitis. CASE PRESENTATION: We report a rare series of four adult patients who presented to our Emergency Department during a period of only one week in April 2015 and were ultimately diagnosed with acute epiglottitis. Three of the patients improved with conservative measures and were observed in the intensive care unit. One patient required an emergent tracheostomy. DISCUSSION: This series of patients is unique in that all four patients presented to a single Emergency Department within a few days of each other and, despite a myriad of presenting chief complaints, the patients were eventually found to have the same potentially life-threatening diagnosis.These cases reinforce the variability of presenting symptoms and physical examination findings that can occur in patients with epiglottitis. They also highlight clinical findings and adjunctive testing that can help identify patients who would most benefit from intervention.
INTRODUCTION: Emergency Departments are inundated by patients with respiratory illness during the winter months. Emergency physicians are required to quickly identify critically illpatients among the large volume of patients with mild upper respiratory illness. Among these life-threatening conditions is acute epiglottitis. CASE PRESENTATION: We report a rare series of four adult patients who presented to our Emergency Department during a period of only one week in April 2015 and were ultimately diagnosed with acute epiglottitis. Three of the patients improved with conservative measures and were observed in the intensive care unit. One patient required an emergent tracheostomy. DISCUSSION: This series of patients is unique in that all four patients presented to a single Emergency Department within a few days of each other and, despite a myriad of presenting chief complaints, the patients were eventually found to have the same potentially life-threatening diagnosis.These cases reinforce the variability of presenting symptoms and physical examination findings that can occur in patients with epiglottitis. They also highlight clinical findings and adjunctive testing that can help identify patients who would most benefit from intervention.
Authors: Tomasz Chroboczek; Martin Cour; Romain Hernu; Thomas Baudry; Julien Bohé; Vincent Piriou; Bernard Allaouchiche; François Disant; Laurent Argaud Journal: PLoS One Date: 2015-05-06 Impact factor: 3.240